scholarly journals Transient elastography for diagnosis of portal hypertension in liver cirrhosis: Is there still a role for hepatic venous pressure gradient measurement?

Hepatology ◽  
2007 ◽  
Vol 45 (5) ◽  
pp. 1087-1090 ◽  
Author(s):  
Joseph K. Lim ◽  
Roberto J. Groszmann
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Pressure Gradient ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Hepatic Venous Pressure Gradient ◽  
Gradient Measurement

scholarly journals Acute and 14-Day Hepatic Venous Pressure Gradient Response to Carvedilol and Nebivolol in Patients With Liver Cirrhosis

Medicina ◽  
2013 ◽  
Vol 49 (11) ◽  
pp. 73 ◽  
Author(s):  
Vilma Silkauskaite ◽  
Jouzas Kupčinskas ◽  
Andrius Pranculis ◽  
Laimas Jonaitis ◽  
Vitalija Petrenkiene ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Pressure Gradient ◽  
Venous Pressure ◽  
Hepatic Venous Pressure Gradient ◽  
Alternative Drug

Background and Objective: Alternative drug therapies are needed for the treatment of portal hypertension.[...]

scholarly journals The cut-off value of transient elastography to the value of hepatic venous pressure gradient in alcoholic cirrhosis

2021 ◽  
Vol 27 (1) ◽  
pp. 197-206
Author(s):  
Se Ri Ryu ◽  
Jeong-Ju Yoo ◽  
Seong Hee Kang ◽  
Soung Won Jeong ◽  
Moon Young Kim ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Pressure Gradient ◽  
Transient Elastography ◽  
Venous Pressure ◽  
Liver Stiffness ◽  
Alcoholic Cirrhosis ◽  
Hepatic Venous Pressure Gradient ◽  
Ratio Score ◽  
Noninvasive Method ◽  
Cutoff Value

Background/Aims: The hepatic venous pressure gradient (HVPG) reflects portal hypertension, but its measurement is invasive. Transient elastography (TE) is a noninvasive method for evaluating liver stiffness (LS). We investigated the correlation between the value of LS, LS to platelet ratio (LPR), LS-spleen diameter-to-platelet ratio score (LSPS) and HVPG according to the etiology of cirrhosis, especially focused on alcoholic cirrhosis.Methods: Between January 2008 and March 2017, 556 patients who underwent HVPG and TE were consecutively enrolled. We evaluated LS, LPR, and LSPS according to the etiology of cirrhosis and analyzed their correlations with HVPG.Results: The LS value was higher in patients with alcoholic cirrhosis than viral cirrhosis based on the HVPG (43.5 vs. 32.0 kPa, P<0.001). There were no significant differences in the LPR or LSPS between alcoholic and viral cirrhosis groups, and the areas under the curves for the LPR and LSPS in subgroups according to HVPG levels were not superior to that for LS. In alcoholic cirrhosis, the LS cutoff value for predicting an HVPG ≥10 mmHg was 32.2 kPa with positive predictive value (PPV) of 94.5% and 36.6 kPa for HVPG ≥12 mmHg with PPV of 91.0%.Conclusions: The LS cutoff value should be determined separately for patients with alcoholic and viral cirrhosis. In alcoholic cirrhosis, the LS cutoff values were 32.2 and 36.6 kPa for predicting an HVPG ≥10 and ≥12 mmHg, respectively. However, there were no significant differences in the LPR or LSPS between alcoholic and viral cirrhosis groups.

scholarly journals Hepatic venous pressure gradient measurement in patients with liver cirrhosis: A correlation with disease severity and variceal bleeding

Medicina ◽  
2009 ◽  
Vol 45 (1) ◽  
pp. 8 ◽  
Author(s):  
Vilma Šilkauskaitė ◽  
Andrius Pranculis ◽  
Dalia Mitraitė ◽  
Laimas Jonaitis ◽  
Vitalija Petrenkienė ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Disease ◽  
Pressure Gradient ◽  
Esophageal Varices ◽  
Variceal Bleeding ◽  
Venous Pressure ◽  
Hepatic Venous Pressure Gradient ◽  
Grade Ii ◽  
The Mean ◽  
Gradient Measurement

The aim of present study was to evaluate relationships between degree of portal hypertension, severity of the disease, and bleeding status in patients with liver cirrhosis. Patients and methods. All study patients with liver cirrhosis underwent hepatic venous pressure gradient measurements, endoscopy, clinical and biochemical evaluation. Liver function was evaluated according to Child-Turcotte-Pugh (Child’s) scoring system. Patients with decompensated cirrhosis (presence of severe ascites, acute variceal bleeding occurring within 14 days, hepatorenal syndrome, cardiopulmonary disorders, transaminase levels >10 times higher the upper normal limit), active alcohol intake, use of antiviral therapy and/or beta-blockers were excluded from the study. Results. One hundred twenty-eight patients with liver cirrhosis (male/female, 67/61; mean age, 53.8±12.7 years) were included into the study. Etiology of cirrhosis was viral hepatitis, alcoholic liver disease, cryptogenic and miscellaneous reasons in 57, 49, 14, and 8 patients, respectively. Child’s stages A, B, and C of liver cirrhosis were established in 28 (21.9%), 70 (54.9%), and 30 (23.4%) patients, respectively. The mean hepatic venous pressure gradient significantly differed among patients with different Child’s classes: 13.8±5.3 mm Hg, 17.3±4.6 mm Hg, and 17.7±5.05 mm Hg in Child’s A, B, and C classes, respectively (P=0.003). The mean hepatic venous pressure gradient in patients with grade I, II, and III varices was 14.8±4.5, 16.1±4.3, and 19.3±4.7 mm Hg, respectively (P=0.0001). Since nonbleeders had both small and large esophageal varices, patients with large varices were analyzed separately. The mean hepatic venous pressure gradient in patients with large (grade II and III) varices was significantly higher than that in patients with small (grade I) varices (17.8±4.8 mm Hg vs 14.6±4.8 mm Hg, P=0.007). Thirty-four (26.6%) patients had a history of previous variceal bleeding; all of them had large (20.6% – grade II, and 79.4% – grade III) varices. In patients with large varices, the mean hepatic venous pressure gradient was significantly higher in bleeders than in nonbleeders (18.7±4.7 mm Hg vs 15.9±4.7 mm Hg, P=0.006). Conclusions. Hepatic venous pressure gradient correlates with severity of liver disease, size of varices, and bleeding status. Among cirrhotics with large esophageal varices, bleeders have a significantly higher hepatic venous pressure gradient than nonbleeders. Hepatic venous pressure gradient measurement is useful in clinical practice selecting cirrhotic patients at the highest risk of variceal bleeding and guiding to specific therapy.

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